Even as AI and pre-payment accuracy loom large on their roadmaps, TPAs must not lose sight of the fact that post-pay reimbursement inaction remains a common everyday reality. The concept of recouping paid dollars isn't new, but it is evolving — and plan administrators must ask themselves if they are using those measures effectively.
Post-pay reimbursement is not about potential savings but refunding actual dollars that go right to the bottom line. Recovering up to 1% of annual claim spend in reimbursements can make a profound impact. And there are numerous levers to mitigate leakage through changes in approach, mindset, and technology, without intensive capital investment or buildout.
This conversation between PBA President Jeff Walter and Intellivo CEO Laura Hescock will explore PBA's post-pay reimbursement journey and what the company has learned. This is a must-attend for TPA executives and operational leaders, as well as benefits and claims administrators at self-insured health plans.
During the webinar, Jeff and Laura will cover:
- PBA's post-pay reimbursement playbook
- Fostering a mindset shift around member abrasion and member retention in regard to cost savings
- PBA's experience with subrogation, including:
- Why it made sense for PBA to move from "pend and pursue" to "pay and pursue"
- Finding reimbursement opportunities – the role of an external data ecosystem
- Why "no member contact" is paramount
- What stop-loss carriers need from TPAs when it comes to subrogation efforts
- The fiduciary aspects of post-pay reimbursement and putting the right procedures in place to protect plan dollars
